Traumatic vulvar hematomas: conservative versus surgical management.

TLDR: A retrospective review of patients treated for vulvar hematomas at the University of North Carolina Hospitals between 1975 and 1991 found that conservative management was often successful in the absence of acute hematoma expansion.

Abstract: Background Vulvar hematomas are relatively uncommon and usually result from blunt trauma. They are more commonly diagnosed in postpartum patients, but hematomas after straddle-type injuries, coitus, or physical assault have been reported. Conservative and surgical management have both been advocated as the appropriate initial treatment. Methods In this study, we have done a retrospective review to obtain data that might indicate a clinical benefit for either conservative or surgical management. We reviewed the charts of patients treated for vulvar hematomas at the University of North Carolina Hospitals between 1975 and 1991. Cases were separated into obstetric and nonobstetric and conservatively and surgically managed groups. Results Of the 29 cases reviewed, 19 were classified as obstetric and 10 were nonobstetric. All 13 obstetric hematomas and 3 of 7 nonobstetric hematomas managed conservatively resolved without subsequent surgical intervention. Conclusion In the absence of acute hematoma expansion, conservative management was often successful.